synonyms: colar bone fracture
Clavicle Fracture Nonunion ICD-10
- S42.001P - Fracture of unspecified part of right clavicle, subsequent encounter for fracture with malunion
- S42.002P - Fracture of unspecified part of left clavicle, subsequent encounter for fracture with malunion
- S42.009P - Fracture of unspecified part of unspecified clavicle, subsequent encounter for fracture with malunion
Clavicle Fracture Nonunion ICD-9
- 733.81 Malunion of fracture
Clavicle Fracture Nonunion Etiology / Epidemiology / Natural History
Clavicle Fracture Nonunion Anatomy
- S shaped: anterolateral surface is concave, convex on anteromedial surface.
- First bone to ossify, 5th gestational week
- Only long bone to ossify be intramembranous ossification
- Medial physis=80% of longitudinal growth
- Both acromial and sternal physes can remain open into 3rd decade of life
- Middle 1/3 fractures typically heal with the lateral shaft fragment displaced posterior to the medial shaft fragment / anterior-posterior angulation. (Edleson JG, JSES 2003;12:173).
- Diameter of medullary canal is approximately 7mm at its narrowest point. (Andermahr J, Clin Anat 2006;20:48).
- See also Shoulder Anatomy.
Clavicle Fracture Nonunion Clinical Evaluation
- Patients complain of; shoulder weakness, fatigue, paresthesias, cosmetic deformity, pain at rest or with activity, asymmetry.
- Pain over clavicle, crepitus.
- Ptosis of affected shoulder.
Clavicle Fracture Nonunion Xray / Diagnositc Tests
- A/P view of clavicle and 30°-45º cephalic tilt view of clavicle.
- Apical oblique (Grashe with 20 cephalad)
- Abduction Lordotic (after ORIF)
- Serendipity view (helps with A/P displacement)
- Zanca 15 degree apical oblique (AC joint)
Clavicle Fracture Nonunion Classification / Treatment
Clavicle Fracture Nonunion Associated Injuries / Differential Diagnosis
Clavicle Fracture Nonunion Complications
- Neurovascular Injury
- Hardware failure (Brouwer KM, JSES 2008 IP)
- Sequelae of clavicle fractures: shoulder weakness, fatigue, paresthesias, cosmetic deformity, pain at rest or with activity, asymmetry.
Clavicle Fracture Nonunion Follow-up Care
Clavicle Fracture Nonunion Review References